Angelo Celli and research on the prevention of malaria in Italy a century ago

The parasite responsible for severe malaria (Plasmodium falciparum) has recently been demonstrated to have been transmitted to humans from gorillas, a finding that substantiates an earlier hypothesis that malaria spread from monkeys to early neolithic peasants at the dawn of land cultivation. The first written records of seasonal and/ or intermittent fevers – which arewidely assumed to be malaria – are found in Sumerian, Babylonian, Assyrian, Chinese, Egyptian and Indian texts. In the fifth century BCE, these fevers became widespread in ancient Greece, prompting Hippocrates to investigate them and to attempt a detailed description. He tried to understand the relationship between the timing and frequency of intermittent fevers and the swelling of the spleen, as well as their relationship to where patients lived, identifying swampy areas as particularly inhospitable. These intermittent fevers affected the inhabitants of wetlands in and around ancient Rome, a situation most probably aggravated by population flows from North Africa around the time of the Punic wars. Some classical civilizations – for example, the Etruscans – channeled water flows and drained marshes, although this may have been primarily for land reclamation. In 1717, the Italian physician Giovanni Lancisi described factors associated with intermittent fevers and postulated that mosquitoes might have a role in transmitting them. Lancisi gave the word malaria its present medical meaning. The word began to be adopted in Italian and English medical texts in the eighteenth century, the word itself reflecting the popular belief that malaria was caused by stagnant air (‘mal’aria’) rising from swampy areas.